Hospitalists Share Strategies to Overcome Career-Related Struggles

LAS VEGAS—If she said it once, Patience Reich, MD, SFHM, said it a half-dozen times during SHM’s annual meeting: “Let it go.”

“You can’t be Martha Stewart and a perfect doctor. Just let it go,” said Dr. Reich, associate professor of internal medicine and associate faculty for the Office of Women in Medicine and Science at the Wake Forest School of Medicine in Winston-Salem, N.C., told about 75 female hospitalists during a two-hour workshop focused on women’s issues at the Mandalay Bay Resort and Casino. “Even in 2014, there are trade-offs to be made.

“We judge ourselves too harshly. … We’re doing ourselves a disservice by saying we should be able to do it all. There are only so many hours in the day. Men don’t worry about these things. Just let it go.”

Dr. Reich and Rachel George, MD, MBA, CPE, SFHM, of Cogent Healthcare, have been moderating the workshop at SHM meetings for several years. They said the issues they encounter among hospitalists around the country, which are no different today than they were in years past, include gender bias, career advancement challenges, and the guilt some feel spending time away from their children or communicating with their stay-at-home husbands.

At HM14, workshop attendees searched for solutions to common struggles.

“Don’t pretend you can have it all,” Dr. George said. “It’s a myth ruining womankind. There’s nothing that says you have to be June Cleaver and Marcus Welby all rolled into one. We have to stop thinking that we have to do it.”

Dr. George told the workshop attendees that cooking and cleaning are so far down on her priority list that “they practically don’t exist.”

“It’s OK. My kids are happy and healthy,” she said. “It doesn’t matter if they come home to a dirty house or if they eat pizza. They’re going to survive. I think women put all that guilt on themselves. Some of it society does, but a lot of women put the guilt on themselves just because they don’t cook a three-course meal every night.”

Open Forum

The issues were much the same during a Special Interest Group attended by nearly 35 hospitalists and moderated by Melissa Mattison, MD, FACP, SFHM, of Beth Israel Deaconess Medical Center in Boston. Topics ranged from personal experiences with workplace discrimination to apprehension in pursuing leadership roles to “partner envy” and dealing with the “guilt” of being a working parent.

One hospitalist wondered how others dealt with harassment from patients. “I’m young, petite, and a minority,” she said. “I get ‘sweetie’ and ‘honey’ all the time from my patients.”

Another explained the difficulty of working full time while taking care of an elderly parent. Yet another admitted her desire for a role model, “as there are none in my area.”

“Men seem to have an innate drive to be the breadwinner,” one attendee said. “No matter how much help you have at home, it doesn’t take away the guilt I feel.”

Another said, “I think about all of these issues constantly.”

Dr. Mattison, a member of the annual meeting committee, left the 45-minute open forum with four action items:

Increase the exposure of programming for issues related to work-life balance at annual meeting;

Suggest keynote speakers who are not men;

Create a toolkit for HM leaders and department of medicine leaders to help them understand work-life issues; and

Create a community on the HMX portal to discuss work-life issues, “whether they are related to being a mother or father, juggling work and home, or whatever issues come up.”

The Key: Flex Schedules

Many physicians who choose a career in HM do it because of the work-life balance the specialty affords, and many of the challenges women hospitalists face at the local level revolve around the schedule. That’s how Zenobia JonesFoster, MD, MPH, a hospitalist at Wellstar Health in Atlanta, views it.

“I think it’s very facility-dependent. I think when we look for a job and decide where we want to go, we really need to understand the culture and how people advance within that culture,” said Dr. JonesFoster, who attended the women’s issues workshop. “The academic environment has a lot more deferred policy and bureaucracy versus a private institution, but you’re going to find that anywhere.”

A hospitalist for a little more than two years, Dr. JonesFoster has two young children, ages one and three, and works in a group with 30 full-time hospitalists and 10 nurse practitioners and physician assistants. Her husband is a businessman, so schedules and work-life balance are a major concern.

“If I was given a job opportunity Monday through Friday, regular work hours, there’s no way I would take it because of the flexibility of hospital medicine hours, with the seven-on seven-off schedule,” she said. “The time I have off, I get to just be a mom and not think about work. But when I’m at work, I love it.”

Dr. JonesFoster’s group has seen an increase in patient census recently and just went live with a new hospital-wide electronic health records system, which has opened up more shifts and moonlighting opportunities. Attending her first annual meeting, she was most interested in learning the pros and cons of leadership positions, because her health system “offers a lot of opportunity for advancement” and is “talking about adding a residency program.”

“Another thing I wanted to learn about was mentorship,” she said. “I wanted to meet women who have done this before, who have had children, who are working full-time trying to do a little bit of everything. I wanted to see how they did it and try and learn from their experiences.”